Multimodal ultrasound assessment of ovarian reserve

Ovarian reserve represents the quantity and quality of a woman's remaining oocytes and serves as a key indicator of reproductive potential. Accurate and non-invasive evaluation of ovarian reserve is essential for guiding fertility management, predicting ovarian response, and monitoring age-related or pathological decline. With the advancement of imaging technology, multimodal ultrasound has emerged as a promising tool for comprehensive ovarian assessment. Two-dimensional (2D) and three-dimensional (3D) ultrasound, Doppler imaging, shear wave elastography (SWE), contrast-enhanced ultrasound (CEUS), and artificial intelligence (AI)-driven imaging together provide complementary insights into ovarian morphology, vascularity, and tissue stiffness. These modalities allow quantitative, reproducible, and real-time assessment of ovarian reserve, enabling early detection of diminished ovarian reserve (DOR) and premature ovarian insufficiency (POI). Moreover, AI-assisted analysis enhances diagnostic consistency and efficiency, paving the way for precision reproductive medicine. In conclusion, the integration of multimodal ultrasound technologies offers a comprehensive, non-invasive framework for evaluating ovarian reserve, supporting individualized fertility assessment and improving reproductive outcomes.